Desmoplakin-Related Arrhythmogenic Cardiomyopathy Carriers and Desmosomal-Type Acantholysis: A Previous Description of the Keratinocyte “Fingerprint Sign”. Comment on Metze et al. Desmosomal-Type Acantholysis—A New Histologic Pattern Related to Mutations of Genes for Desmosomal Proteins. Dermatopathology 2026, 13, 17

Q: What is the clinical evidence from this study?

Study design: Letter. Population: Arrhythmogenic cardiomyopathy. Intervention: Heterozygous truncating desmoplakin (DSP) variants. Primary outcome: Subclinical cutaneous phenotype (keratinocyte fingerprint sign).

Q: What does this research mean for the field?

The keratinocyte 'fingerprint sign' is a previously described histologic feature of desmosomal-type acantholysis in carriers of desmoplakin-related arrhythmogenic cardiomyopathy. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Angel Fernández‐Flores

doi:10.3390/dermatopathology13030039

August 31, 2026DermatopathologyOpen Access

Desmoplakin-Related Arrhythmogenic Cardiomyopathy Carriers and Desmosomal-Type Acantholysis: A Previous Description of the Keratinocyte “Fingerprint Sign”. Comment on Metze et al. Desmosomal-Type Acantholysis—A New Histologic Pattern Related to Mutations of Genes for Desmosomal Proteins. Dermatopathology 2026, 13, 17

View Full Paper

Ask AI

Bookmark

Share

Key result

Heterozygous carriers of truncating desmoplakin variants with arrhythmogenic cardiomyopathy exhibit a subclinical cutaneous phenotype characterized by a keratinocyte fingerprint sign.

Key Points

To contextualize earlier observations of a subclinical cutaneous phenotype and the keratinocyte 'fingerprint sign' within the newly defined framework of desmosomal-type acantholysis.
Commentary evaluating histopathologic and ultrastructural cutaneous features previously documented in a cohort of heterozygous carriers of truncating desmoplakin (DSP) variants with arrhythmogenic cardiomyopathy.
Histopathologic assessment, desmoplakin immunohistochemistry, transmission electron microscopy, and trichogram analyses were reviewed.
Heterozygous truncating DSP variant carriers presented with widening of intercellular spaces, loss of intercellular adhesion, focal acantholysis in the spinous layer, and reduced desmoplakin expression despite lacking macroscopic skin abnormalities.
A striated cytoplasmic pattern resembling dermatoglyphic lines, termed the 'fingerprint sign', was identified in keratinocytes across all evaluable cases, alongside pseudomonilethrix on trichograms.
Ultrastructural examination confirmed enlargement of intercellular spaces, elongation of cytoplasmic bridges, and a reduced number of desmosomes in a subset of patients.

Structured PICO

P

Population

Heterozygous carriers of truncating desmoplakin (DSP) variants associated with arrhythmogenic cardiomyopathy

Implication

The subclinical cutaneous 'fingerprint sign' in patients with DSP-related arrhythmogenic cardiomyopathy should be recognized as part of the desmosomal-type acantholysis spectrum, aiding in multidisciplinary evaluation.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Angel Fernández‐Flores (2026) conducted a letter in Arrhythmogenic cardiomyopathy. Heterozygous truncating desmoplakin (DSP) variants was evaluated on Subclinical cutaneous phenotype (keratinocyte fingerprint sign). Heterozygous carriers of truncating desmoplakin variants with arrhythmogenic cardiomyopathy exhibit a subclinical cutaneous phenotype characterized by a keratinocyte fingerprint sign.

synapsesocial.com/papers/6a97e305c562ede874ec798a https://doi.org/10.3390/dermatopathology13030039

View Full Paper

Ask AI

Bookmark

Share

Key Points

Structured PICO

Implication

Discussion

Cite This Study

Key Points

Structured PICO

Implication

Discussion

Cite This Study

Keep reading

Keep reading